EagleTribune.com, North Andover, MA

Merrimack Valley

September 6, 2009

The line forms to the left: Waiting for care under health reform

Waiting for care under health reform proposal

Will waiting lines at doctors' offices, labs and hospitals get longer if President Barack Obama's vision of health care reform becomes a reality?

And who will decide if a patient is eligible for a treatment or procedure?

It will probably come as no surprise that expert opinion on that is divided — sharply divided — between those who support the president's initiative and those who don't. And there is no way to predict the future with certainty.

But essentially, it is yet another debate over rationing — longer waits for care would be a form of rationing.

It is important to note, as those on both sides of the issue frequently have, that rationing already exists within the current health care system. Most people do some self-rationing — choosing whether to treat themselves for non-life-threatening illnesses or injuries rather than going to the doctor. Insurance companies ration by not paying for every procedure or service people want. There are waiting lines as well, because there is not an unlimited supply of doctors or high-technology equipment.

So the question is: Will the proposed health care reform increase the delays for treatment, procedures or doctor appointments?

Not according to its backers.

Judy Feder, a senior fellow with the liberal-leaning Center for American Progress, is among those who say lines may actually get shorter, because primary care doctors will no longer spend so much time on unnecessary testing, procedures and burdensome paperwork.

Indeed, it sounds like a matter of simple math. If fewer things are being done for individual patients, then doctors can accommodate more patients.

Feder said the legislation will create incentives for "better" medicine, rather than "more" medicine. She said the current fee-for-service model rewards doctors for doing more things, while reform will reward them for "getting it right."

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